Rhinoplasty or nose surgery for a septal perforation is a complicated procedure. A septal perforation can occur due to many causes such as previous nasal surgery, trauma, intranasal drug use, or Afrin abuse. The perforation must be symptomatic to warrant closure. Symptoms might include poor nasal breathing, crusting, bleeding, and whistling due to the septal perforation. Closing a septal perforation is a difficult task. The patient must stop and refrain from any future habits that may have caused the issue initially. The septal perforation must be small enough and oriented in a way that is closeable.
The approach to a septal perforation is similar to that of a rhinoplasty or nose job. The perforation is closed and a piece of fascia or alloderm is placed in between the flaps. Splints are typically left in for 3-4 weeks to allow the closure site to heal without dry air blowing across it. Success rates (100% closure) with the appropriately chosen perforations are 80-90%.